Comments to CMS on a 2020 Proposed Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Other Issues

The Business Group submitted comments on a proposed rule (CMS- 1734-6) commenting on proposed changes to site-of-service, adding prior authorization requirements for certain procedures, transforming care delivery and quality and transparency provision.

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October 02, 2020

Specifically, the Business Group supported CMS efforts to

  • Phasing out the Inpatient Only (IPO) List over a 3-year period (beginning in calendar year (CY) 2021).
  • Permitting Medicare to pay for an expanded set of procedures at ambulatory surgery centers (ASCs), typically a lower cost site of care, if they do not pose significant safety risks.
  • Adding a prior authorization requirement for Cervical Fusion with Disc Removal and Implanted Spinal Neurostimulators,
  • Reducing or eliminating unnecessary or modifying burdensome requirements for providers.
  • Making a number of changes to improve quality and transparency under the Medicare program.

Comments to CMS on a 2020 Proposed Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Other Issues

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